Duration of SARS-CoV-2 viremia and its correlation to mortality and inflammatory parameters in patients hospitalized for COVID-19: a cohort study

Hagman, Karl; Hedenstierna, Magnus; Rudling, Johan; Gille-Johnson, Patrik; Hammas, Berit; Grabbe, Malin; Jakobsson, Jan; Dillner, Joakim; Ursing, Johan

doi:10.1016/j.diagmicrobio.2021.115595

Cited by 36 publications

(37 citation statements)

References 30 publications

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“…Similar to previous reports that SARS-CoV-2 viremia is positively correlated with acute COVID-19 severity and is a predictor of mortality 27, 28 , we found that Spike protein is positively correlated with peak WHO score (p=0.0351) during hospitalization. We also observed that Spike protein is positively correlated with length of hospitalization (p=0.0359) which is of particular concern because prior research has shown that longer duration of SARS-CoV-2 viremia is associated with greater risk of mortality 29 . It also appears that a decreased production of early functional, neutralizing antibodies is a predictor of COVID-19 severity and may also explain why Spike protein is correlated with peak WHO score and length of hospitalization due to lack of clearance by cell-mediated immunity 22, 23 .…”

Section: Discussionmentioning

confidence: 62%

Persistent Presence of Spike protein and Viral RNA in the Circulation of Individuals with Post-Acute Sequelae of COVID-19

Craddock

Mahajan

Krishnamachary

et al. 2022

Preprint

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SARS-CoV-2, the causative agent of COVID-19 disease has resulted in the death of millions worldwide since the beginning of the pandemic in December 2019. While much progress has been made to understand acute manifestations of SARS-CoV-2 infection, less is known about post-acute sequelae of COVID-19 (PASC). We investigated the levels of circulating SARS-CoV-2 components, Spike protein and viral RNA, in patients hospitalized with acute COVID-19 and in patients with and without PASC. In hospitalized patients with acute COVID-19 (n=116), we observed a positive correlation of Spike protein with D-dimer, length of hospitalization, and peak WHO score while viral RNA correlated with a tissue injury marker, lactate dehydrogenase (LDH). When comparing patients with post-COVID symptoms (n=33) and patients without (n=14), we found that Spike protein and viral RNA were more likely to be present in patients with PASC and in some cases at higher levels compared to acute COVID-19 patients. We also observed that the percent positivity of circulating viral RNA increased in the PASC positive individuals compared to acute COVID-19 group while Spike protein positivity remained the same. Additionally, we report that part of the circulating Spike protein is linked to extracellular vesicles without any presence of viral RNA in these vesicles. Our findings suggest that Spike protein and/or viral RNA fragments persist in the recovered COVID-19 patients with PASC, independent of their presence or absence during the acute COVID-19 phase.

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Section: Discussionmentioning

confidence: 62%

Persistent Presence of Spike protein and Viral RNA in the Circulation of Individuals with Post-Acute Sequelae of COVID-19

Craddock

Mahajan

Krishnamachary

et al. 2022

Preprint

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“…Some authors have referred to the detection of SARS-CoV-2 RNA in blood as RNAemia [13, 24, 30]. However, we use the expression “viremia” for this determination, as the presence of viral RNA in the blood, in line with other published studies [ 17 , 23 , 31 , 32 , 33 ], since in approximately 80% of the studied plasma samples 2 or 3 SARS-CoV-2 genes were detected.…”

Section: Discussionmentioning

confidence: 90%

Usefulness of real-time RT-PCR to understand the kinetics of SARS-CoV-2 in blood: A prospective study

Zurita-Cruz

Martín-Ramírez

Rodríguez-Serrano

et al. 2022

Journal of Clinical Virology

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“…25,26 Assessment of SARS-CoV-2 viremia can help in risk stratification of hospitalized COVID-19 patients, distinguishing patients in the replication phase, who could benefit from early antiviral treatment, from those found in the inflammatory phase, who could benefit more from other treatments. 3,27,28 SARS-CoV-2 detection in plasma of COVID-19 patients is associated with severe disease and unfavorable outcome, 8,19,29,30 but in many studies, viremia is measured in a single sample or not quantified. To date, it has not been explored whether certain specific SARS-CoV-2 viremia kinetics may be associated with an increased risk of poor outcomes in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Relevant SARS‐CoV‐2 viremia is associated with COVID‐19 severity: Prospective cohort study and validation cohort

Domingo

Roy-Vallejo

Cruz

et al. 2022

Journal of Medical Virology

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Background Early Kinetics of SARS‐CoV‐2 viral load (VL) in plasma determined by quantitative RT‐PCR was evaluated as a predictor of poor clinical outcome in a prospective study and assessed in a retrospective validation cohort. Methods Prospective observational single‐centre study including consecutive adult patients hospitalised with COVID‐19 between November 2020 and January 2021. Serial plasma samples were obtained until discharge. Quantitative RT‐PCR was performed to assess SARS‐CoV‐2 VL. The main outcomes were in‐hospital mortality, admission to the Intensive Care Unit (ICU) and their combination (Poor Outcome). Relevant Viremia (RV), established in the prospective study, was assessed in a retrospective cohort including hospitalised COVID‐19 patients from April 2021‐May 2022, in which plasma samples were collected according to clinical criteria. Results Prospective cohort: 57 patients were included. RV was defined as at least a two‐fold increase in VL within ≤2 days or a VL>300 copies/mL, in the first week. Patients with RV (N=14; 24.6%) were more likely to die than those without RV (35.7% vs 0%), needed ICU admission (57% vs 0%) or had Poor Outcome (71.4% vs 0%), (p<0.001 for the three variables) Retrospective cohort: 326 patients were included, 18.7% presented RV. Patients with RV compared with patients without RV had higher rates of ICU‐admission [OR 5.6 (95%CI,2.1‐15.1); p=0.001], mortality [OR 13.5 (95%CI,6.3‐28.7); p<0.0001] and Poor Outcome [OR 11.2 (95%CI,5.8‐22); p<0.0001] Conclusion Relevant SARS‐CoV‐2 viremia in the first week of hospitalisation was associated with higher in‐hospital mortality, ICU admission, and Poor Outcome. Findings observed in the prospective cohort were confirmed in a larger validation cohort. This article is protected by copyright. All rights reserved.

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Duration of SARS-CoV-2 viremia and its correlation to mortality and inflammatory parameters in patients hospitalized for COVID-19: a cohort study

Cited by 36 publications

References 30 publications

Persistent Presence of Spike protein and Viral RNA in the Circulation of Individuals with Post-Acute Sequelae of COVID-19

Persistent Presence of Spike protein and Viral RNA in the Circulation of Individuals with Post-Acute Sequelae of COVID-19

Usefulness of real-time RT-PCR to understand the kinetics of SARS-CoV-2 in blood: A prospective study

Relevant SARS‐CoV‐2 viremia is associated with COVID‐19 severity: Prospective cohort study and validation cohort

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